A Retrospective Study on Alopecia Areata in Children: Clinical Characteristics and Treatment Choices

Skin Appendage Disord. 2021 Nov;7(6):454-459. doi: 10.1159/000518042. Epub 2021 Sep 14.

Abstract

Background: Although children are affected frequently with alopecia areata (AA), data are limited on clinical characteristics and treatment choices.

Materials and methods: We retrospectively reviewed the records of the pediatric dermatology department over a 12-year period to identify children with AA. Clinical data were collected.

Results: Three hundred and sixty-four children with AA were identified, aged 1-12 years, 214 males and 150 females. The mean age of onset was 6.6 years (±3.3). The disease presented with patches on the scalp in the majority (90.7%), whereas only 6 children had alopecia totalis or universalis. The most commonly prescribed treatment was topical steroids (69.1%), followed by the combination of topical steroids and minoxidil 2% (14.3%). Oral steroids were prescribed in only 16 children. Follow-up at 3 months was available for only 70 children and the majority (84.3%) had some hair regrowth. Hair regrowth was unrelated to the number of plaques (p = 0.257), disease location (p = 0.302), and atopy (p = 0.999). Hair regrowth only correlated with the type of treatment (p = 0.003) with potent topical and intralesional steroids giving the best results.

Conclusion: AA usually presents with a mild form in children, and potent topical steroids are the mainstay of treatment.

Keywords: Alopecia areata; Males; Minoxidil; Ophiasis; Topical steroids.